Research Brief
A new study published in the Journal of Internal Medicine shores up support for post-exertional malaise and exercise limitations in chronic fatigue syndrome. It also demonstrates a change in pain threshold after exercise.
Researchers monitored participants before, during and after bouts of exercise. They found that the people with chronic fatigue syndrome not only felt substantially worse after exercising, their pain thresholds dropped. In healthy participants, pain thresholds went up.
The pain threshold marks the point at which the body interprets sensation as painful. That means things that would not have caused pain before exercise will cause it afterward, which could at least partially account for the increase in overall pain people with chronic fatigue syndrome experience.
Researchers concluded that this provides evidence of abnormal central pain processing during exercise. They recommend more study to identify what kinds and amounts of exercise people with the condition can do without making themselves worse.
This is the second recent study tying chronic fatigue syndrome to pain states that are similar to those found in fibromyalgia. The earlier study demonstrated hyperalgesia, which is essentially the body "turning up the volume" of pain signals.
Post-exertional malaise if often considered the hallmark symptom of chronic fatigue syndrome. It's a major spike in fatigue, pain and flu-like symptoms following exertion that lasts for a least 24 hours. Several research teams believe that studying this symptom will lead them to unique biomarkers which could be used as a diagnostic test.
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YaY!
Oh, this is so cool! I did exercise yesterday before I went for some electrolysis. Usually it doesn’t bother me much, but it was quite painful that day. I couldn’t figure out why, but now I know. Interesting!
Hurray!
Thanks for keeping us up-to-date, Adrienne.
As someone with both CFS and fibromyalgia for many years, I know all about “post-exertional malaise”. The term sounds a whole lot better than how it really feels — like being run over by a truck!
I have had cfs for over twenty-five years and have long suspected dopamine/endorphin depletion to be a factor in chronic fatigue syndrome and an inability to restore dopamine levels in the brain. Dopamine can act like a brake, which might help explain why some with cfs experience post-exertional fatigue and pain syndromes. If you are depleted in dopamine, the body has nothing to work with to control pain etc. (running on empty). Anything that increases the depletion of dopamine/endorphins (stress, exercise etc.) will cause more fatigue, flu-like-symptoms and pain. The immune system becomes hyper-reactive.
This is soooo true. I have FMS and CFS with complications of RA and two other arthritis diseases. I have found a personal trainer who I am working with who REALLY UNDERSTANDS the problems we have. Even though we only live a bit more than an hour apart, we are doing everything via Skype (other teleconferencing could be used too, we just haven’t tried them yet. I am loosing weight and gaining energy in what I think is a miracle! But I just had to do some really heavy physical work — yard work at my old home to get it ready for sale, and cleaning at my new home because it came with a lot of dirt! That was two days ago and I am still recovering. I can barely hold my eyes open. But getting over the sugar threshold and starting real easy exercises started helping me immediately. Thanks to About.com! I think your website is one of the most important sites in the Internet. Thanks, Krissy
What you describe is a failure of the DNIC(Descending Neuromodulatory Inhibitory Control) fibers to function properly. It is fairly well established that people who suffer from Fibromyalgia and CFS have very limited activity in DNIC fibers. These fibers decrease the discomfort we experience during times of stressful activity and are analogous to the “runner’s high”. It has been demonstrated that DNIC can be improved with exercise, regardless of who you are. It just takes longer in patients with Fibromyalgia and related illnesses such as Chronic Fatigue Syndrome. The moral of the story is don’t give up, just increase activity VERY slowly.